RecruitingACTRN12623001284651

Ultrasound measurement of unstable shoulders before and after taping and rehabilitation treatment

Effect of taping and rehabilitation on humeral head position and translation in unstable shoulders: an ultrasound study

Sponsor

La Trobe University

Enrollment

15 participants

Start Date

Dec 19, 2022

Study Type

Interventional

Conditions

Shoulder instability

Summary

This is the second component of a masters project that is investigating humeral head position and translation in unstable shoulders. In this pre- and post-intervention study, we aim to investigate the effect of taping and rehabilitation on humeral head position and/or translation in unstable shoulders. We hypothesise that humeral head inferior position/translation will reduce and that these findings will correlate with other measured improvements of shoulder position, strength, pain, and function.

Eligibility

Sex: Both males and femalesMin Age: 18 YearssMax Age: 35 Yearss

Inclusion Criteria5

Symptomatic subluxation or dislocation inferiorly +/- anterior or posterior direction
Positive sulcus test
Improvement in range of motion in abduction by >20 degrees, OR improvement of pain or guarding in abduction, OR improvement in strength on an isometric test
Intervention 2 - Rehabilitation: Participants must be enrolled in a rehabilitation
program with a practitioner trained to implement the Watson Instability Program (WIP)

Exclusion Criteria7

History of significant trauma to the shoulder
History of surgery on the affected shoulder
Unable to understand or follow instructions in English
Known neurological pathology creating motor deficit
Known upper or lower motor neurone disease
Known connective tissue disorder (Ehlers Danlos / Marfan syndrome)
Presence of cervical radiculopathy

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Interventions

This study involves 2 interventions (taping and rehabilitation. All participants will be offered to be part of the taping group and the rehabilitation group. They can decide whether to be part of one, the other, or both. This design may be classified as a before-and-after study involving two interventions. Intervention 1 - Taping Fixomul hypoallergenic tape and rigid sports tape. Scapular taping into upward rotation. Experienced physiotherapist with over 10 years of experience. Individual face-to-face treatment. One treatment session - the tape application takes less than 5 minutes. Administered at a private physiotherapy clinic in Melbourne, Australia. Adherence will not be monitored as follow-up data is taken immediately after the tape application. Intervention 2 - Rehabilitation Rehabilitation will be overseen by the participants' treating physiotherapist who has been trained in the Watson Instability Program (Watson, et al., 2016, 2017). Progression through the program is determined by the treating physiotherpist and typically occurs in the treatment sessions. Exercises are typically of low-moderate intensity and focus on low-load, high repitition dosages. E.g. shoulder shrug against red theraband 1-3 sets, 20 reps, 5 secs, 1-3 x daily. Other exercises may include, but may not be limited to: - row (low/high) - external rotation (low/high) - internal rotation (low/high) - pushing (low/high) - lateral raise (low/high) Treatment may be individualised/tailored as determined by the treating physiotherapist. Treatments may include, but are not limited to: Exercise prescription/progression, massage, stretching, joint mobilisation, and taping. Equipment may include therabands, handweights, and gym equipment as deemed necessary by the treating physiotherapist. Treatment may be delivered face-to-face, or via telehealth, or via a mixture as determined by the treating physiotherapist The number/frequency of sessions over a twelve week period will be determined by the treating physiotherapist but typically last 20-30 minutes, once per week (13 sessions). Treatments will be administed through a private physiotherapy clinic in Melbourne, Australia. Adherence will be overseen by the treating physiotherapist and may include strategies such as patient education, booking appointments ahead of time, and follow-up contact where appropriate. Attendence will be recorded by the treating physiotherpist in the clinic's practice management software. REFERENCES: Watson, L., Warby, S., Balster, S., Lenssen, R., & Pizzari, T. (2016). The treatment of multidirectional instability of the shoulder with a rehabilitation program: Part 1. Shoulder & elbow, 8(4), 271-278. doi:10.1177/1758573216652086 Watson, L., Warby, S., Balster, S., Lenssen, R., & Pizzari, T. (2017). The treatment of multidirectional instability of the shoulder with a rehabilitation programme: Part 2. Shoulder & elbow, 9(1), 46-53. doi:10.1177/1758573216652087